Pill box

If an individual has taken a medication and experienced symptoms such as a skin rash, itching, swelling, severe gastrointestinal symptoms, breathing problems and/or decreased blood pressure, our board-certified allergists and immunologists can help. Patients can either call themselves or ask their physician to refer them for a drug allergy evaluation.

Drug allergy patients of all ages can be seen at any of our three allergy and immunology clinics. We also offer appointments in a Drug Allergy Specialty Clinic at our West County and Central West End locations.

  • Common drugs associated with allergic reaction include, but are not limited to:
  • Penicillin/amoxicillin
  • Other antibiotics
  • Perioperative drugs (surgery-related)
  • Local anesthetic agents such as those used during dental appointments
  • Aspirin
  • Chemotherapy drugs

COVID-19 Vaccine

If you have had an allergic reaction to your COVID-19 vaccination, you can be evaluated by our physicians to determine if you should receive the vaccination again in the future. Call 314-996-8670 to schedule an appointment at one of our three allergy and immunology clinics.

Most drug allergy patients only require one visit with our specialists. Our physicians will evaluate the suspected reaction to the drug based on the history provided by the patient and determine if skin testing is necessary to diagnose an allergy. If testing is negative, a dose challenge may be performed — the patient is given doses of the drug in clinic and closely monitored by the allergist for a reaction. If the patient is able to tolerate the medication in clinic with no reaction, then this clears the patient of the drug allergy.

If an allergy is diagnosed, the most common treatment is to avoid the problematic medication and let health care providers choose an alternative. If there is not an alternative medication, our specialists can also design a drug desensitization protocol. This is a process by which the drug is divided into multiple doses and administered slowly, so the patient can build a temporary tolerance to help them complete a course of therapy. This can be done with drugs such as antibiotics, chemotherapy agents, and aspirin.

Research has shown that drug allergy is over diagnosed, particularly with penicillin drugs. It has been shown that a hospitalized patient labelled with a drug allergy to penicillin has a longer hospital stay, increased risk of complications from alternative antibiotics given, and incur a higher cost due to the alternative agents used. Even if a patient had a severe allergic reaction to penicillin in the past, after 10 years, the risk of the drug allergy still being present is low. This is why 90 percent of people evaluated for penicillin allergy are found to be able to tolerate penicillin.

Jennifer Monroy, MD, currently sees drug allergy patients during the morning on the third Friday of every month at the Asthma & Allergy Center – West County and first Monday of every month at the Highlands location in the Central West End. She also sees all allergy-related patients, including asthma patients, at all three of our locations.

John T. Milliken Department of Internal Medicine
Washington University School of Medicine
660 S. Euclid Ave.
MSC 8122-0021-03
St. Louis, MO 63110
Phone: 314-996-8670
Fax: 314-996-3195